- "Schema" are enduring thought patterns learned early on that filter our view of the world and how to interact with it.
- Understanding the maladaptive schema of personality-disordered people can help put their behaviors into perspective.
- Personality-disorder-related core schema include abandonment, incompetence, control, belonging, suspiciousness, entitlement, and status.
Personality disorders (PDO) are puzzling, and you probably find yourself asking, "Why do personality-disordered people act the way they do!?" Knowing each one's chief, maladaptive core belief (schema) can help put their exasperating behaviors into perspective. Considering that thoughts motivate feelings, which encourage actions, getting an inside look at each PDO's foundational thought, readers can easily see how the vexing behavioral patterns unfold.
Understanding the Personality Disorder/Schema Nexus
Core beliefs are often referred to as schema in psychology, particularly in the world of personality disorders. Personality expert Dr. Joseph Shannon (2016) explained, "A schema is an extremely-stable and enduring pattern of thinking that is learned in childhood or adolescence. We view ourselves, others, and the world around us through our schema." Given this, it's no surprise that disordered personalities are rooted in early maladaptive core schema (e.g., Nordahl et al., 2005; Kunst et al., 2020).
In light of the previous paragraph, the point of therapy with personality-disordered patients is to confront disruptive core schema and construct more adaptive ones. Recognizing this, psychologist Jeffrey Young developed "schema therapy" as a way to more directly confront these cognitive pillars of interpersonal turmoil, which has been notably successful (e.g., Jacob & Arntz, 2013; Dadomo et al., 2018).
Core Schema of Each DSM-5 Personality Disorder
The following is a snapshot of each PDO's presentation per the DSM-5, followed by the general maladaptive core schema driving its presentation.
Antisocial: Someone with a disregard for, and violation of, the rules of society and the rights of others.
"Rules are for fools. Nobody looks out for me; I'm looking out for number one and doing whatever is necessary to get what I want."
Avoidant: An individual with a penchant for negative self-evaluation in comparison to others that leads to social inhibitions.
"I'm so inept, undesirable, and stupid that no one would ever want to be with me. My undesirable characteristics are irrepressible and easily detected, and therefore I'll always be seen as 'less-than.'" (Shannon, 2016)
Considering this PDO is not as well-known as others, curious readers can find an example in the cartoon character Charlie Brown.
Borderline: People whose greatest fear is abandonment/rejection and who display a pattern of significantly-unstable moods, self-image, and impulse control that leads to tumultuous interpersonal relationships.
"I'm a victim, you're my savior. You're either entirely accepting of me or entirely rejecting me, period."
Dependent: A person whose excessive need to be taken care of engenders submissive and clinging behaviors.
"I'm incompetent and incapable, so rely on fastening myself to others, so they can care for me and make my decisions.
Histrionic: An excessively-emotional individual who relies on being the center of attention.
"Unless I dramatically seek attention, I'll be invisible and forgotten and never feel cared for."
Narcissistic: An individual whose grandiosity/entitlement and need to be admired/dominant robs them of the ability to empathize with others.
"Status, wealth and power trump all other values, and others could never meet my expectations." (Shannon, 2016)
"Failure is unacceptable, and in order to not fail, I must be very focused on control of myself and my environment, including people."
Paranoid: People with an inordinate amount of distrust, who are compelled to be suspicious of the motives and intentions of others.
"People will invariably, intentionally, betray, or otherwise take advantage of me. It always pays to be wary of others."
Schizoid: Someone who seems to neither desire nor require close, interpersonal relationships, or being in touch with their feelings.
"The world, especially dealing with emotions and other people, is overwhelming. I can't juggle all the stimulation; an insular life, unplugged of emotion is much more manageable."
Schizotypal: A being whose discomfort with the world-at-large dictates an existence of dissociation from their environment via eccentric thinking and behaviors, and sometimes outright dissociative episodes.
"I don't understand the world around me. It's better to secede and create my own world to live in."
Readers interested in the spectrum of maladaptive schema of each PDO are encouraged to read Millon (2011), who examines the intrapsychic content of each at length. McWilliams (2013), and Young (1999) also offer expansive material on the matter. Yudofsky (2005) illustrates how maladaptive schema can evolve in several PDOs and offers a bird's-eye view of altering them during therapy sessions.
Disclaimer: The material provided in this post is for informational purposes only and not intended to diagnose, treat, or prevent any illness in readers. The information should not replace personalized care from an individual's provider or formal supervision if you’re a practitioner or student.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Dadomo, H., Panzeri, M., Caponcello, D., Carmelita, A., Grecucci, A. (2018). Schema therapy for emotional dysregulation in personality disorders. Current Opinion in Psychiatry, 31 (1), 43-49 doi: 10.1097/YCO.0000000000000380
Jacob, G. & Arntz, A. (2013). Schema therapy for personality disorders: A review. International Journal of Cognitive Therapy, 6(2). https://doi.org/10.1521/ijct.2013.6.2.171
Kunst, H., Lobbestael, J., Candel, I.,& Batink, T. (2020). Early maladaptive schemas and their relation to personality disorders: A correlational examination in a clinical population. Clinical Psychology and Psychotherapy, 27(6), 837-846. https://doi.org/10.1002/cpp.2467
McWilliams, N. (2013). Psychoanalytic diagnosis: Understanding personality structure in the clinical process, (2nd ed.). Guilford
Millon, T. (2011). Disorders of personality: Introducing a DSM/ICD spectrum from normal to abnormal (3rd ed). Wiley.
Nordahl, H., Holthe, H., & Haugum, A. (2005). Early maladaptive schemas in patients with or without personality disorders: does schema modification predict symptomatic relief? Clinical Psychology and Psychotherapy, 12(2), 142-149.
Shannon, Joseph W. (2016, September 29). Reasoning with unreasonable people: Focus on disorders of emotional regulation. Brattleboro Retreat, Brattleboro, Vermont.
Young, J.E. (1999). Cognitive therapy for personality disorders: A schema-focused approach, (3rd ed). Professional Resource Exchange.
Yudofsky, S. (2005). Fatal flaws: Navigating destructive relationships with people with disorders of personality and character. American Psychiatric Publishing.